Chapter 9
To prevent the cramp returning, means must be adopted to increase vital energy in the system. Entire mental rest for an hour after meals must be taken. If the patient says "I cannot get this," then he simply will soon have to give up all work, and perhaps narrowly escape a departure from this working world altogether.
Each morning before rising, the compress should be applied as above for a short time; the back should then be rubbed with hot olive oil before dressing. This treatment, and proper rest, will prevent return of the cramp. If the patient falls asleep on the compress, allow this sleep to continue unbroken: it is invaluable. So also is the avoidance of all anxious thought, which is best secured by complete trust in a loving God and Saviour.
Croup, Less Serious Form.--The less serious croup proceeds from a nervous closing of the windpipe, the attack being brought on by any causes of irritation in the nervous system. In this case, when the fit reaches a certain stage, the throat opens, and breathing proceeds as usual. This croup is a cramp of the windpipe; the cramp is caused by an irritation of the nerves controlling it, which are already in a condition to be easily irritated. The cure is to apply cooling cloths to the spine. Take the child warm in bed in the morning, and rub the little back with warm olive oil. Ring out a towel of _cool_, not quite cold, water; fold this into a narrow compress, and place it along the spine; place a dry towel above it and wrap up warm. Change for a fresh cool towel in two or three minutes. If the child falls asleep on this, leave him till he wakes voluntarily. Rub the back again with oil before dressing. The cooling may continue for an hour or so. If this treatment fail, the child may be given medicine to produce vomiting, which frequently relieves. Before putting to bed at night wash the child all over with plenty of M'Clinton's SOAP (_see_), dry and rub over with warm olive oil. Continue this treatment for some days.
Croup, More Serious Form.--This is caused by an accumulation of material in the windpipe, which is coughed up in pieces of pipe-like substance, and which, if not removed, threatens suffocation. For treatment, first give sips of hot water (distilled water is best) frequently. We have seen only five teaspoonfuls of this taken by a child followed by the throwing off of such a quantity of matter from the throat as had nearly caused suffocation. The further treatment is the bran poultice between the shoulders, and cold cloths on the chest, as prescribed in the article on Bronchitis. These may not cure in all cases, but will do so in many apparently otherwise hopeless. The moment the symptoms are perceived, treatment should be begun, as this disease is very rapid in its progress.
When an actual attack of croup of this kind comes on, and is severe, it is usual to put the child in a warm bath. If the water is a little below blood heat, and laved on the back, this will go far to relieve; but it will not have a tenth of the effect which a cold towel will have, if placed along the spine. It is indeed wonderful how spasms and the various forms of cramp give way to this. When a little warm olive oil is first rubbed on and then off, there is no danger of cold or of any bad effect (_see_ Cramp in Stomach). If this croup is obstinate, there may be more serious disease of the throat, and good medical advice should be had.
Cures Losing their Effect.--After a fortnight's treatment often matters seem to come to a standstill in a case, and then the attendants are apt to despair. Such a state of things indicate only the need for some change in treatment, or perhaps for a rest from treatment for some days. Common sense must guide, and the case may be more keenly looked into: it may have changed its character in the time that has passed, and different treatment require to be given. It is well not to give up until all has been tried which in any way seems likely to suit the case. All the various articles bearing on it should be carefully read and pondered, and no doubt the way to change the treatment will open up. _See_ Changing Treatment.
Cures, as Self-Applied.--Often young people in lodgings are in difficulty for want of some one to apply the necessary treatment in their own case. It is often, however, possible to treat oneself quite successfully by exercising care and common sense. Help should always be got if possible, but where it cannot, it may be done without. In the case of applying cold cloths to any part, when it is necessary to change these frequently, a basin of cold water may stand by the bedside so that the patient can wring out towels without getting up. A still better plan is to have several towels wrung out to begin with--these may be hung over a rail or chairs until required. When the first has been heated it must be hung over the rail or chair so as to be as much spread out as possible. Evaporation will then cool it sufficiently to be used when its turn comes again. Each towel is to be treated in a similar way in turn. Four towels will give an hour's cooling with very little trouble in this way. So a bran poultice may be prepared and laid on the bed, so that one can lie down on it, and with the cold towels handy, as above, most effective treatment given. Common sense is the guide here, as everywhere in our treatment, and a little thought will solve difficulties at first apparently insoluble.
Damp Beds.--An ordinary bed which has not been slept in for some weeks, although perfectly dry to begin with, will _become_ damp, even in a dry house, and, unless properly dried, will be a great danger to its next occupant. This is a preventable danger, and all who entertain guests should see that they are not exposed to it. Many a fatal illness is due to the culpable carelessness of those who put a guest into such a bed. Ignorance in such a matter is shameful. All who have charge in a house should fully understand their responsibility in this matter.
But if you are put into such a bed it is infinitely better to rise and dress, and make the best of a night of discomfort, than to sleep among the damp. If, however, you have so slept, and feel the bad effect, the best cure will be the SOAPY BLANKET (_see_). If this cannot be had, a good hot footbath, with the heat kept just comfortable for half-an-hour or more, will do very well. This should be done at the earliest possible moment.
It will add greatly to the efficiency of such treatment if hot water can be had to drink in small quantities, and often. A few drops of cayenne "tea" in the water will act as a gentle stimulant. Old-fashioned folk place great confidence in a "hot drink" in such a case. This is all very well if they only keep the alcohol out of it: that destroys vital resources, but never supplies them. We have known cases in which all power was lost through a single night in a damp bed. Possibly in these cases it might not have been easy to restore the lost vitality by any amount of treatment; but we rather think that a speedy application of genial heat all over would have restored it. In some apparently hopeless instances it has done so.
Deafness.--_See_ Hearing.
Decline.--_See_ Consumption.
Declining Limb, A.--_See_ Limbs, Drawn up.
Delirium in Fever.--The best way of treating this truly distressing symptom is by cooling and soothing applications to the head. We have seen in one case large cool cloths applied to the head for some time every three hours or so. An almost immediate cessation of the delirium followed this application, and it only returned a few minutes before the time for the next cooling. If the pulse becomes rather slow than rapid, and the body rather cool than hot, while delirium still continues, then hot cloths may be applied to the head. When either hot or cold appliances are removed, rub olive oil into the roots of the hair, and dry off.
An excellent treatment is also to cover the whole head with soap lather. _See_ Head, Soaping.
It is to be noted that the state of the patient determines the treatment. If he is hot, cold treatment is required. If he is cool or chilly, then give the warm treatment. If he _changes_ from hot to cold, then alter the treatment accordingly.
In some diseases delirium occurs, not because of fever, but because of poisonous elements in the blood supplied to the brain. This is the case in liver and kidney troubles, when waste products are not got rid of by these organs as they should be.
To get these organs to work, the best thing is to drink half a teacupful of hot water every ten minutes for two hours at a time. Do this once a day for two days. Probably it will cause purging, but that is part of the cure. If the case does not yield in any way to this, a large hot bran poultice should be placed over the whole of the _right_ side under the arm, from the spine right round to the breast-bone (_see_ Bran Poultice). This should be renewed if necessary, so as to keep up the heat for an hour. Next day place a similar poultice over all the lower part of the back, so as to help the kidneys and bowels. Dry after these poultices, and rub gently with warm olive oil. The delirium will usually yield to a few days of such treatment. We have seen the reason under such treatment return with a rapidity that astonished the medical attendant. He had given the patient three months to gain what was complete in less than one. _See_ Fever.
Depression.--This is usually a bodily illness, though often regarded as mental only. It appears in loss of interest in all that otherwise would be most interesting. A mother loses interest in her children, a man in his business, and so on. Students, and children overpressed at lessons, are apt to suffer from it. It is simply the result of a drain of energy from the system, until the brain has an insufficient supply. Those who have the care of the young would do well to watch carefully against this state coming on. If it appears, all work should be given up, and as much play take its place as possible. No cramming of ideas into a weakening mind can ever be equal to the possession of health and energy, as a preparation for life.
Treatment should be such as to restore energy. The whole back should be fomented with a large blanket fomentation, being rubbed with olive oil before and after. Let this be done for an hour in the morning; in the evening give the ARMCHAIR FOMENTATION (_see_). Carry this on for a week, and then rest for another week, only rubbing the back with a little hot olive oil each night. Cultivate open-air life; sleep as much as possible--eight hours at least, or better nine. Carefully prepared and easily digested food should be given, and change of company, scene, and climate are most effective helps; but rest from work is the chief matter. _See_ Restlessness and Worry.
Diabetes.--There are two more or less distinct stages of this serious trouble; the first stage is generally curable, the second stage generally incurable. Yet good natural means of cure will very much alleviate even the incurable stage. The earlier as well as the later stages are marked by extreme _thirst_. This, in the case of some poor sufferers, is enormous. Gallons of water are taken, and the more is taken the more is wanted. But this thirst is not the effect of heat, as fever thirst is. It cannot be quenched by means of cold cloths often changed over the stomach, as fever thirst can. A sufferer in this disease will set a large pitcher down at the bedside to serve for the night, and drink it all before morning; but there is no extra heat anywhere to account for this. The thirst is more like that which is caused by eating very salt food. It points to the character of the juices which are affecting the stomach, and not to any heated condition of the stomach itself. The drinking is a desperate effort to dilute these juices; and, at least by cold water, that cannot be done. A wineglassful of hot water taken every ten minutes for an hour, or two hours, or three, or ten hours, as is felt to be comfortable, will do wonders in the early stages of this disease. This water, when taken at the right heat, at once mixes with the strongly concentrated juices of the stomach, and causes them to be easily managed by that and other organs. It is truly wonderful what this very simple remedy will effect by itself alone. The next thing to be noticed is the excessive hunger. The food, whatever it may be, fails to quell this hunger. Here, again, it is clearly the stomach with which we have to do. When the hunger is developed we should think the case further advanced than when thirst alone is experienced. The hot water meets this symptom as it meets the other. It is also of the very greatest moment to give right food. Oatmeal and buttermilk steeped together for a time and then moderately boiled, a very little salt or sugar being added, produces a food which we do not expect to see excelled by the most costly that can be got anywhere. Wheaten meal, or barley meal, will do as well as, and perhaps in some cases better than, oatmeal, but these may be chosen according to taste. The chief thing is the ease with which this food is converted into a large supply of the best of blood for all purposes of nourishment. Food containing much starchy matter, as white bread, rice, and all sugar, must be forbidden. To make up for this, an abundance of fat should be consumed. The bowels should be kept open by a suitable diet and exercise.
Now we come to the excessive urinary discharge which is so strong a feature of this disease. The body seems as if it were melting away in this.
We can benefit the kidneys vastly through acting on the liver, as well as on themselves. By a large hot bran poultice over the liver we can add new life to that, and whatever does so tends to benefit the kidneys. After using this large poultice, with plenty of oil rubbed on before and after, say three or four times, place it over the kidneys and use it as often there. If the heat is well kept up for an hour at a time, one poultice a day would do, but, if the patient desires it, twice a day will be all the better. It is good to do the best that can be done with the skin. By means of soap and oil rubbing, and the cleansing effects of diluted acetic acid, very considerable help may be gained. Good can be done by a hot fomentation of the feet and legs to the knees, with oiling after, so as to have these extremities in a comfortable state. Tea, coffee, and sugar _must be avoided_.
Diarrhoea.--Sudden attacks of this, though in a mild form, are very troublesome. An enema of _cold_ water is in such cases often an immediate cure. The first injection may be followed by even an excessive motion, but if a second cold injection be given this will cease. But in more troublesome cases, where the patient is an infant, or very weak, this is not applicable. For such cases, mix equal quantities of honey and lemon juice (one or two teaspoonfuls of each), and add enough boiling water to dilute it for taking. Give this three or even four times a day. It will usually and speedily cure, and is relished by infants.
Often the cause of diarrhoea in infants is the infection of milk by flies (_see_ British Cholera), or from dirty feeding bottles. Bottles with tubes should _never_ be used. The india-rubber teat should be smelt to see that it is perfectly sweet and clean before the bottle is filled. Unsuitable or too rich food will bring this trouble on.
A tablespoonful of blackberry (or brambleberry as it is also called) jelly may be given--it is a powerful and simple remedy. In adults, a dose of castor oil, with a few drops of laudanum in it, will probably remove all trouble, if it be due to nothing more than indigestible food. Where the cold enema is dreaded, one of hot thin starch, with fifteen drops of laudanum in it, may be used for adults.
Stale vegetable or animal food, also impure water, are fruitful sources of diarrhoea.
The mind has a great effect on this trouble, anxiety and worry are frequent causes. _See_ Worry. A comfortable seat by the fire, and an interesting book, will often relieve.
When the diarrhoea is very serious, use the four-ply flannel bandage. _See_ Bandage; British Cholera; Dysentery.
Diet.--The composition of different articles of food varies. A turnip is not the same as a piece of cheese. It is more watery, and has more fibre in it, and we speak of it as less nutritious. There are, however, in almost all foods certain chemical substances present which have different duties to perform in the body, and which are present in widely different proportions in the various articles we use for food.
_Water_ is the most common of these substances. Soups, vegetables, fruits, puddings, are largely water. Some foods contain less of it than others, but on the whole a very large, if not the largest, part of all food consists of water. This large amount is needed. Water makes up two-thirds of the body, and nearly two quarts are given off daily in the various excretions and secretions. If enough be not taken the tissues get dry, and Nature indicates her want in thirst.
Another of these substances is _starch_, or its equivalent, sugar. Rice, bread, and vegetables in general, are largely made up of this starchy or sugary substance, which, as it contains a considerable quantity of carbon, we speak of as the _carbonaceous_ element in food. This is the substance which goes to feed the muscles, replacing the waste from work done, just as fuel is required for the fires of an engine.
Yet another substance in food is _fat_. It may be animal, such as beef or mutton fat, and butter, or vegetable, as the oils in nuts, in the olive, etc. Fat, like carbonaceous food, also goes to feed the muscles, but both are required in a healthy diet.
Of the first importance, however, is the _proteid_ element in food. Meat, milk, cheese, eggs, peas, etc., contain proteid in considerable quantities. Its use is to repair the exhausted tissues themselves. The muscles and nerves get worn out in their daily work, and require rebuilding. This is what proteid goes to do, and from this, its high import in animal economy, is called Proteid (protos--first). Finally, in all natural foods there are certain _salts_, which also build up, _e.g._, lime, which goes to make up bone. These salts may be seen in the ash of any common vegetable after being burnt.
These four kinds of food substance make up our daily food, and a certain amount of each substance is required to replace the daily expenditure, a proportion which varies, however, under different circumstances. _See_ Food in Health.
As the relative amount of proteid, carbonaceous matter, water, and salts, may vary considerably in different articles, we rightly have combinations of food at our meals. A pudding of corn-flour and water contains no building material, hence we add milk and eggs, which do. A meal of meat and cheese requires bread and potatoes, etc., etc.
Appetite is a good test of the amount and also of the particular kind of food required, provided the appetite is in a healthy condition. If a healthy man refrain from carbonaceous foods for a day or so, he feels a great longing for them, a sign that the body really needs them. It is of immense importance, then, that the appetite should not be accustomed to over-indulgence, for then it is no guide in our selection of foods (_see_ Appetite). If disease indicates such over-indulgence, food should be restricted till the appetite is accustomed to a smaller diet. Bilious people, for example, may have accustomed their appetite to desire more carbonaceous and fatty foods than necessary. On the contrary, badly-fed people often require a coaxing of the appetite to eat strengthening foods, such as oatmeal, cheese, and brown bread.
In order to regulate our diet, it is of importance to have some idea of the composition of common articles of food. We get our food, as everybody knows, from the vegetable and animal kingdoms. The majority of the Anglo-Saxon race live on a diet of animal and vegetable combined, but many exclude flesh from their diet. In Southern Asia, for example, the vast bulk of the people rarely, or never, touch meat. The vegetable kingdom supplies us largely with the carbonaceous or muscle-forming food, whereas the animal kingdom is rich in proteid, or tissue-forming food. Much proteid, however, can be obtained from the vegetable kingdom--peas, beans, lentils, dried fruits, and nuts being particularly rich in it. We should endeavour to cultivate an appetite for these vegetables containing proteid, as it is a great mistake to rely entirely for this element on meat, as so many of our race do. The animal products--such as cheese, milk, and eggs--will also form an efficient substitute for much flesh-food. This simple diet suits both the brain-worker and the athlete, though each will have to make a selection of those foods most required by him. Certainly much animal food is liable to produce kidney disease, gout, and kindred troubles. If we have a tendency to corpulence (and many have this in advancing years), to resort to an exclusive meat diet will produce these troubles. Far better abstain from vegetables, such as potatoes, and from sweet dishes, pastry, etc., and eat largely of the green-leaf vegetables and fruits with the articles of a simple diet which build but do not fatten the body. (_See_ Diet and Corpulence; Diet for Middle Age, and the Aged.)
Fruit is a very useful article of food. The acid helps to keep the blood alkaline (which alkalinity is necessary for the normal performance of its functions). It prevents acidity of the stomach. The dried fruits, such as dates, figs, raisins, are very rich in proteid. Nuts also are rich in proteid and in fat; they require, however, careful mastication. Mills can be purchased cheaply for grinding nuts; the ground meal, either alone or made into a cream, forms a delicious adjunct to stewed fruit.
Green vegetables are a much neglected food. The salts they contain are very useful. They require careful cooking. A cabbage boiled in the ordinary way loses in the water its valuable salts. In case of flatulence arising from indigestion, the use of vegetables may, however, require to be restricted, at least for a time. Some vegetables are palatable raw, such as salads and celery. Indeed, raw vegetables have a tonic effect on the bowels.
Bread should never be too fresh, and should be thoroughly chewed. Zwieback (twice baked) can be recommended, especially for those who suffer from indigestion. It is made by cutting bread, preferably wheaten, in thin slices, and putting these in a slow oven till thoroughly dry and lightly browned. Wholemeal bread should always be present on the table, as its use prevents constipation. Indian corn can be made into a number of palatable cakes, and is a very nutritious food. Home-made jam and honey are digestible forms of sugar, but like all sugar foods should be consumed in moderation, especially by sedentary individuals. Condiments should be avoided, the healthy appetite is better without them, and they irritate the stomach.